By: Abigail Lee

After last week’s Republican debates, vaccines are in the news again. Donald Trump made a statement claiming a link between vaccination and autism, citing a worker’s child that received a vaccine, developed a fever and became autistic, in that order. Ben Carson, the medical expert among the Republican candidates, cited studies that claimed no link between vaccines and autism. He did, however, distinguished between vaccines that would “prevent death or crippling” and mentioned, but did not specifically name, ones that did not fall into that category. Regardless of politician opinion, most health professionals cite vaccinations as one of the top achievements in public health in the past century. From the creation of the first smallpox vaccine in the 1790s to the increasing number of vaccines in the 21st century, there has been a large reduction in mortality and morbidity. [1] In response to politician statements, public health officials can point to a 2013 CDC study supporting a multitude of other research concluding that vaccines do not cause autism. [2]

While there are varied opinions in our nation on whether vaccinations are beneficial or harmful, it is useful to become educated about the state of vaccination in the United States. We can start by discussing the statistics of vaccinations worldwide and then closely examining vaccination rates in our local Georgia environment.

Although, as a society we are becoming more technologically advanced, immunization rates still vary globally and nationally. The World Bank Data publishes data immunization rates (percentage of children ages 12-23 months) for specific countries. [3] Below is a graph showing the average rate of measles vaccinations in the world and in the United States. In 2005, the average world rate was 76.2% and in 2013 it was 83.9%. The United States had a higher vaccination rate of 92% in 2005 and 91% in 2013. While the world vaccination rate has increased within the past decade, the United States’ rate slightly decreased.

For a more comprehensive breakdown of the United States’ measles vaccinations statistics, the Center for Disease Control and Prevention (CDC) published vaccine coverage by state in a recent issue of the Morbidity and Mortality Weekly Report (MMWR). The CDC covers “National, State and Selected Local Area Vaccination Coverage Among Children Aged 19-35 Months.” [4] They publish vaccination data for hepatitis A, B, DtaP, poliovirus, MMR, Hib, Varicella, PCV, Rotavirus, and combined series as well as children who received no vaccinations.

The states are separated by US Department of Health and Human Services (HHS) by region, state and local areas. Georgia is part of the HHS Region IV along with Alabama, Florida, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee.

In Georgia,

94.2% received greater than one dose of MMR vaccine compared to the average 92.8% HHS Region,

85.7% received more than 4 doses of DTaP compared to 85%

78.4% compared to 72% for Hepatitis B.

The national average for these vaccines are 91.5%, 84.2%, and 72.4%, respectively.

According to other research from Georgia’s Immunization Program, the state’s childhood immunization rates peaked in 2004 at 81% and dropped to 78% in 2008. Within the metro Atlanta area, immunization rates varied from 93% in Gwinnett County to 69% in Clayton. In Fulton County, which is where the city of Atlanta resides, the rate was below 75%. [5] Speaking to the notion that location plays a large role in rates of vaccination, Dr. Saad Omer, an infectious disease epidemiologist at Emory’s Rollins School of Public Health stated, “We have found through our work that people who refuse vaccinations cluster geographically.” [6] It seems we need to emphasize addressing vaccinations through specific regions, towns and cities. These clusters are particularly dangerous for herd immunity, a means of protecting a community from a disease by immunizing a critical mass of its population. As a result, vaccination protects more than just the vaccinated person as the vaccination can break the chain of the infection’s transmission. Recent events in Disneyland Park, California this past winter highlighted the idea of regional clusters in the recent outbreak of measles. In 2000, the CDC declared that measles was eliminated from the United States, reporting only low numbers in certain areas or cases that originated from outside the country. However, throughout the early months of 2015, there were 133 confirmed cases of measles. The recent outbreak of measles sparked a debate over the enforcement of vaccination laws and exemptions.

Researchers at the Boston Children’s Hospital believe there is a link between those who contracted measles and concentrations of low vaccination rates. They analyzed case numbers reported from the California Department of Public Health and found that the vaccination rates for the outbreak areas were somewhere between 50% to 86%, which is much lower than the 96% to 99% rate needed to create herd immunity. [7] Therefore, the disease was able to reach the unusually high rate of 133.As we have seen in the state of California, there are certain areas of under-vaccination that allow disease to quickly spread. Factors that contribute to this lack of vaccination include region, race, socioeconomic status, personal, religious, and philosophical reasons. There is an increasing amount of debates over vaccinations and exemptions, so it is useful to keep in mind geographical vaccination rates and the implications they have on health. The outbreak in California helped officials reevaluate the state’s vaccination law, revoking personal beliefs as a justification for exempting children from vaccines required to attend public school. In conjunction with the state’s previous legislation is the anti-vaccination trend among certain presidential candidates. Although science has repeatedly proved the safety of vaccines, if our political leaders cannot support these facts there is a higher chance of relaxation of vaccine laws.